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May 30, 2012 -- If you have gout, you may want to pass on the liver and keep the anchovies off the pizza.

People who had the highest amounts of compounds called purines in their diets increased their risk of having a gout flare-up by almost five times compared to those eating the least purine-rich foods, a new study shows.

Foods with the highest purine content include liver, organ, and game meats, sardines, mussels, anchovies, herring, and beer.

Although a purine-rich diet has long been considered a risk factor for recurrent gout attacks, this is the first large study to explore this connection and quantify it.

Gout is a type of inflammatory arthritis that affects up to 3 million Americans, according to the American College of Rheumatology. The condition occurs when too much uric acid builds up in the body, which can lead to crystal deposits of uric acid in the joints.

Uric acid comes from the breakdown of purines, which are substances found in all the body's tissues as well as in many foods.

It's not unusual for someone to have their first attack of gout in the big toe, which becomes red, warm, swollen, and extremely painful. Gout is also more likely to occur in men, in people who are overweight, or in those who drink too much alcohol or eat too many high-purine foods.

Purine Intake and Gout Attacks

For the study, which appears in the journal Annals of the Rheumatic Diseases, scientists tracked 633 people with gout and monitored their health online for one year. More than three-quarters of the volunteers were men, and their average age was 54.

During the study period, each person was asked to submit information about any gout attacks they had. These details included any potential triggers and dietary information for the two days leading up to the attack, their symptoms, and what drugs they were taking to manage the condition.

As a comparison, participants also provided this same information over a two-day period every three months when they did not have a gout flare-up.

Purine-rich foods can trigger a gout flare-up relatively quickly -- often within two days of eating higher amounts of them, researchers found.

The odds of a gout flare-up were greater when purine came from animal food sources than from plant sources.

"Avoiding or reducing purine-rich foods intake, especially of animal origin, may help reduce the risk of recurrent gout attacks," the study concludes.